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NPI Code Detail

MEDICARE: MICHAEL RAY WILLIAMS PHD

MEDICARE: MICHAEL RAY WILLIAMS PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling Psychologist10968926-2501UT

General Provider Information

NPI Number : 1437796836
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL RAY WILLIAMS PHD
Provider Business Mailing Address
First Line : 3319 N UNIVERSITY AVE STE 100
Second Line :
City : PROVO
State : UT
Zip : 84604-4447
Country : US
Telephone Number : 801-356-0014
Fax Number :
Provider Business Practice Location Address
First Line : 3319 N UNIVERSITY AVE STE 100
Second Line :
City : PROVO
State : UT
Zip : 84604-4447
Country : US
Telephone Number : 801-356-0014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2019
Last Update Date : 12/04/2019

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